Diffusion weighted imaging can be performed similar to the phase contrast angiography sequence. The gradients must be increased in amplitude to depict the much slower motions of molecular diffusion in the body.
While a T1 weightedMRIpulse sequence is diffusion sensitive, a quantitative diffusionpulse sequence was introduced by Steijskal and Tanner. Its characteristic features are two strong symmetrical gradient lobes placed on either side of the 180° refocusing pulse in a spin echosequence. These symmetrical gradient lobes have the sole purpose of enhancing dephasing of spins, thereby accelerating intravoxel incoherent motion (IVIM) signal loss.
Dephasing is proportional to the square of the time (diffusion time) during which the gradients are switched on and the strength of the applied gradient field. Therefore, the use of high field gradient systems with faster and more sensitive sequences, make diffusion weighting more feasible.
Areas in which the protons diffuse rapidly (swollen cells in early stroke, less restriction to diffusion) will show an increased signal when the echo is measured relative to areas in which diffusion is restricted.
For increased accuracy of diffusion measurement and image enhancement, useful motion correction techniques such as navigator echo and other methods should be used. In addition to this, applying the b-value calculated by the strength and duration of motion probing gradients with a high rate of accuracy is very important.
(DENSE) Displacement Encoding with Stimulated Echoes is a functional cardiac MRIpulse sequence, used to create maps of myocardial displacement with high resolution.
The DENSE magnitude images produce black blood images to show better myocard-blood contrast and to reduce motion artifacts.
WARNING: NEPHROGENIC SYSTEMIC FIBROSIS
Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m2), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.
(Dy) The Dysprosium chelates are analogs of the extracellular gadolinium chelates, with substitution of the dysprosium ion for the gadolinium ion and offers advantages in application on first pass studies.
The use of a dysprosium-based contrast agent (Dy-type) instead of a gadolinium-type (Gd-type) is an alternative in cases of a disrupted blood brain barrier. Because of its much smaller T1 enhancement, this contrast agent should give more accurate perfusion calculations in brain MRI.
A brand name for ferumoxide (same as Feridex®)
Endoremâ„¢ is a black to reddish-brown aqueous colloid of superparamagnetic iron oxide associated with dextran for intravenous administration as a MRIcontrast medium for the detection of liver lesions that are associated with an alteration in the RES.
Endoremâ„¢ is taken up by macrophages, found only in healthy liver cells but not in most tumors. Tissues such as metastases, primary liver cancer, cysts and various benign tumors, adenomas and hyperplasia retain their native signal intensity, so the contrast between normal and abnormal tissue is increased.